reference. FORM 56-1 Annual Registration Statement For the financial year ending DATE MONTH YEAR Company: ............................................................................................... Note

. 2 Registration Statement for Securities Offering (Form 69-1) Company: .......... (Name of Securities Offeror) ….....… Offers for Sale

. - 21 - FORM 56-1 One Report (Attached to Notification No. Tor Jor. 55/2563) Applicable to the Financial Year Ending 31 December 2021 onwards Annual Registration Statement / Annual Report Form 56-1 One